Skip to main content Accessibility help
×
Home

THE IMPACT OF NEW DRUG LAUNCHES ON LIFE-YEARS LOST IN 2015 FROM 19 TYPES OF CANCER IN 36 COUNTRIES

  • Frank R. Lichtenberg (a1)

Abstract:

This study employs a two-way fixed effects research design to measure the mortality impact and cost-effectiveness of cancer drugs: It analyzes the correlation across 36 countries between the relative mortality from 19 types of cancer in 2015 and the relative number of drugs previously launched in that country to treat that type of cancer, controlling for relative incidence. The sample size (both in terms of number of observations and population covered) of this study is considerably larger than the sample sizes of previous studies; a new and improved method of analyzing the lag structure of the relationship between drug launches and life-years lost is used; and a larger set of measures of the burden of cancer is analyzed. The number of DALYs and life-years lost are unrelated to drug launches 0–4 years earlier. This is not surprising, since utilization of a drug tends to be quite low during the first few post-launch years. Moreover, there is likely to be a lag of several years between utilization of a drug and its impact on mortality. However, mortality is significantly inversely related to the number of drug launches at least 5 years earlier, especially to drug launches 5–9 years earlier. One additional drug for a cancer site launched during 2006–2010 is estimated to have reduced the number of 2015 DALYs due to cancer at that site by 5.8%;; one additional drug launched during 1982–2005 is estimated to have reduced the number of 2015 DALYs by about 2.6%. Lower quality (or effectiveness) of earlier vintage drugs may account for their smaller estimated effect. We estimate that drugs launched during the entire 1982–2010 period reduced the number of cancer DALYs in 2015 by about 23.0%, and that, in the absence of new drug launches during 1982–2010, there would have been 26.3 million additional DALYs in 2015. Also, the nine countries with the largest number of drug launches during 1982–2010 are estimated to have had 14% fewer cancer DALYs (controlling for incidence) in 2015 than the nine countries with the smallest number of drug launches during 1982–2010. Estimates of the cost per life-year gained in 2015 from drugs launched during 2006–2010 range between $1,635 (life-years gained at all ages) and $2,820 (life-years gained before age 65). These estimates are similar to those obtained in previous country-specific studies of Belgium, Canada, and Mexico, and are well below the estimate obtained in one study of Switzerland. Mortality in 2015 is strongly inversely related to the number of drug launches in 2006–2010. If the relationship between mortality in 2020 and the number of drug launches in 2011–2015 is similar, drug launches 5–9 years earlier will reduce mortality even more (by 9.9%) between 2015 and 2020 than they did (by 8.4%) between 2010 and 2015.

Copyright

Corresponding author

Address correspondence to: Graduate School of Business, Columbia University, 504 Uris Hall, 3022 Broadway, New York, NY 10027, USA; e-mail: frank.lichtenberg@columbia.edu.

Footnotes

Hide All

Financial support for this research was provided by Incyte Corporation and by the National Institute on Aging (Grant R24 AG048059).

Footnotes

References

Hide All
Acemoglu, Daron and Linn, Joshua (2004) Market size in innovation: Theory and evidence from the pharmaceutical industry. Quarterly Journal of Economics 119 (3), 10491090.
Bertram, Melanie Y, Lauer, Jeremy A, De Joncheere, Kees, Edejer, Tessa, Hutubessy, Raymond, Kieny, Marie-Paule, and Hill, Suzanne R. (2016) Cost-effectiveness thresholds: Pros and cons. Bulletin of the World Health Organization 94 (12), 925930.
Bils, Mark (2004) Measuring the Growth from Better and Better Goods. National Bureau of Economic Research working paper 10606.
Bresnahan, Timothy F. and Gordon, Robert J. (1996) The Economics of New Goods. Chicago: University of Chicago Press.
Brustugun, O. T., Møller, B., and Helland, A. (2014) Years of life lost as a measure of cancer burden on a national level. British Journal of Cancer 111, 10141020.
Burnet, N. G., Jefferies, S. J., Benson, R. J., Hunt, D. P., and Treasure, F. P. (2005) Years of life lost (YLL) from cancer is an important measure of population burden–and should be considered when allocating research funds. British Journal of Cancer 92 (2), 241245.
Centre National Hospitalier d'Information sur le Médicament (2017) Thériaque database. http://www.theriaque.org/apps/contenu/accueil.php
Chien, YiLi (2015) What Drives Long-Run Economic Growth?. Federal Reserve Bank of St. Louis, https://www.stlouisfed.org/on-the-economy/2015/june/what-drives-long-run-economic-growth, accessed 1 June 2018.
Cutler, David, Deaton, Angus, and Lleras-Muney, Adriana (2006) The determinants of mortality. Journal of Economic Perspectives 20 (3), 97120.
Danzon, Patricia M., Richard Wang, Y., and Wang, Liang (2005) The impact of price regulation on the launch delay of new drugs—Evidence from twenty-five major markets in the 1990s. Health Economics 14 (3), 269292.
Dorsey, E. Ray, de Roulet, Jason, Thompson, Joel P., Reminick, Jason I., Thai, Ashley, White-Stellato, Zachary, Beck, Christopher A., George, Benjamin P., and Moses, Hamilton III (2010) Financial anatomy of biomedical research, 2003–2008. Journal of the American Medical Association 303 (2), 137143.
Ferlay, J., Bray, F., Pisani, P., and Parkin, D. M. (2004) GLOBOCAN 2002 Cancer Incidence, Mortality and Prevalence Worldwide, IARC CancerBase No. 5, version 2.0, IARCPress, Lyon.
Fuchs, Victor R. (2010) New priorities for future biomedical innovations. New England Journal of Medicine 363, 704706.
Grossman, Gene M. and Helpman, Elhanan (1993) Innovation and Growth in the Global Economy. Cambridge: MIT Press.
Hercowitz, Zvi (1998) The ‘embodiment’ controversy: A review essay. Journal of Monetary Economics 41, 217224.
IMS Institute for Healthcare Informatics (2015) Medicines Use and Spending Shifts: A Review of the Use of Medicines in the U.S. in 2014, April, https://www.iqvia.com/institute/reports/medicines-use-and-spending-in-the-us-a-review-of-2016, accessed 1 June 2018.
IMS Institute for Healthcare Informatics (2016) Global Oncology Trend Report: A Review of 2015 and Outlook to 2020, June, https://www.iqvia.com/institute/reports/global-oncology-trends-2017-advances-complexity-and-cost, accessed 1 June 2018.
International Agency for Research on Cancer (2017a) WHO Cancer Mortality Database, http://www-dep.iarc.fr/WHOdb/WHOdb.htm, accessed 1 June 2018.
International Agency for Research on Cancer (2017b) GLOBOCAN 2012: Estimated Cancer Incidence, Mortality, and Prevalence Worldwide in 2012, http://globocan.iarc.fr/Default.aspx, accessed 1 June 2018.
International Federation of Pharmaceutical Manufacturers & Associations (2017) The Pharmaceutical Industry and Global Health: Facts and Figures 2017. February, https://www.ifpma.org/wp-content/uploads/2017/02/IFPMA-Facts-And-Figures-2017.pdf.
Jones, Charles I. (1998) Introduction to Economic Growth. New York: W.W. Norton.
Jones, Charles I. (2002) Sources of U.S. economic growth in a world of ideas. American Economic Review 92 (1), 220239.
Jovanovic, Boyan and Yatsenko, Yuri (2012) Investment in vintage capital. Journal of Economic Theory 147 (2), 551569.
Kirch, Wilhelm, ed. (2008) Encyclopedia of Public Health, Berlin Heidelberg: Springer-Verlag.
Lichtenberg, Frank R. (2014) The impact of pharmaceutical innovation on disability days and the use of medical services in the United States, 1997–2010. Journal of Human Capital 8 (4), 432480.
Lichtenberg, Frank R. (2015) The impact of pharmaceutical innovation on premature cancer mortality in Canada, 2000–2011. International Journal of Health Economics and Management 15 (3), 339359.
Lichtenberg, Frank R. (2016a) The impact of pharmaceutical innovation on cancer mortality in Belgium, 2004–2012. Forum for Health Economics and Policy 20, 1.
Lichtenberg, Frank R. (2016b) The impact of pharmaceutical innovation on premature cancer mortality in Switzerland, 1995–2012. European Journal of Health Economics 17 (7), 833854.
Lichtenberg, Frank R. (2017) The impact of pharmaceutical innovation on cancer mortality in Mexico, 2003–2013. Latin American Economic Review 26, 8.
Lichtenberg, Frank R. and Joel, Waldfogel (2009) Does misery love company? Evidence from pharmaceutical markets before and after the orphan drug act. Michigan Telecommunications & Technology Law Review 15 (2): 335.
Murphy, Kevin M. and Topel, Robert H. (2006) The value of health and longevity. Journal of Political Economy 114 (5): 871904.
National Cancer Institute (2017) Enhancing Drug Discovery and Development, https://www.cancer.gov/research/areas/treatment/enhancing-drug-discovery, accessed 1 June 2018.
National Science Foundation (2017) R&D Expenditures by Industry Category, http://wayback.archive-it.org/5902/20150819114914/http:/www.nsf.gov/statistics/nsf00301/expendit.htm#intensity, accessed 1 June 2018.
Nordhaus, William D. (2005) Irving fisher and the contribution of improved longevity to living standards. American Journal of Economics and Sociology 64 (1), 367392.
OECD (2017) OECD Health Statistics database, http://www.oecd.org/els/health-systems/health-data.htm, accessed 1 June 2018.
Patterson, Gregory S. (2012) The Business of Ideas: The Highs and Lows of Inventing and Extracting Revenue from Intellectual Property. AuthorHouse (Bloomington, IN).
Romer, Paul M. (1990) Endogenous technological change. Journal of Political Economy 98 (5, Pt. 2), S71–S102.
Sampat, Bhaven and Lichtenberg, Frank R. (2011) What are the respective roles of the public and private sectors in pharmaceutical innovation?. Health Affairs 30 (2), 332339.
Solow, Robert (1960) Investment and technological progress. In Arrow, Kenneth, Karlin, Samuel, and Suppes, Patrick (eds.), Mathematical Methods in the Social Sciences, 1959, Stanford, CA: Stanford University Press, pp. 89104.
Somaini, Paulo and Wolak, Frank A. (2016) An algorithm to estimate the two-way fixed effects model. Journal of Econometric Methods 5 (1), 143152.
United Nations (2017) Human Development Index (HDI) | Human Development Reports, http://hdr.undp.org/en/content/human-development-index-hdi, accessed 1 June 2018.
World Health Organization (2016a) Global Health Estimates 2015: Disease Burden by Cause, Age, Sex, by Country and by Region, 2000–2015. Geneva: World Health Organization.
World Health Organization (2016b) Global Health Estimates 2015: Deaths by Cause, Age, Sex, by Country and by Region, 2000–2015. Geneva: World Health Organization. http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.html.
World Health Organization (2017a) WHO methods and data sources for global burden of disease estimates 2000-2015, Global Health Estimates Technical Paper WHO/HIS/IER/GHE/2017.1, January, http://www.who.int/healthinfo/global_burden_disease/GlobalDALYmethods_2000_2015.pdf
World Health Organization (2017b) WHO methods and data sources for country-level causes of death 2000-2015, Global Health Estimates Technical Paper WHO/HIS/IER/GHE/2016.3, Department of Information, Evidence and Research, http://www.who.int/healthinfo/global_burden_disease/GlobalCOD_method_2000_2015.pdf.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed